Impact of Cisplatin-induced Hearing Loss on Health-related Quality of Life: A Prospective Cohort Study
A/Prof Lebogang Ramma
Title of the project
Impact of cisplatin-induced hearing loss on health-related quality of life: A prospective cohort study.
Cisplatin is a highly effective and widely used chemotherapeutic drug for treatment of solid tumours. It is also associated with a high incidence of ototoxic hearing loss which affects up to 75% or more of patients who receive the drug. In most developing countries such as South Africa patients who develop cisplatin-induced ototoxicity following cisplatin chemotherapy do not get the necessary audiological intervention and this is likely to have a negative impact on their health-related quality of life (HRQoL). The aim of this study therefore is to determine the impact of cisplatininduced hearing loss on the patients’ HRQoL and explore audiological rehabilitation needs of patients who develop hearing loss following treatment with cisplatin.
A prospective cohort study design will be used to follow-up patients undergoing cisplatin-based chemotherapy treatment at two tertiary public hospitals in Cape Town during 2018-2019. Patients will be recruited from Oncology departments of participating hospitals and they will be sampled via convenience sampling. Only adult patients who receive 100 mg/m2 cisplatin dose per cycle of chemotherapy will be included in this study. Participants who consent to participate in this study will undergo the following assessments: Otoscopy, tympanometry and pure tone audiometry (including ultra-high frequency audiometry: 9-16 kHz). Assessment of hearing thresholds will be done before start the of treatment (i.e. Baseline), during chemotherapy (prior to each cycle of chemotherapy) and at 1 and 3 months post chemotherapy treatment. In addition, all participants will be administered the Short-Form Health Survey (SF-36) at the following intervals: start of treatment (baseline), the last chemotherapy cycle, at 1 and 3 months post the last chemotherapy cycle to assess their HRQoL. Participants who develop disabling hearing loss following chemotherapy treatment will be offered audiological rehabilitation in line with existing protocols at the two participating facilities.
Data will be analyzed using the IBM SPSS statistical package. Descriptive statistics (mean, median and mode) will be used to summarize changes in hearing thresholds post chemotherapy while inferential statistics (t-test) will be used to compare changes in hearing thresholds and HRQoL between participants who developed hearing loss during chemotherapy and those who did not as well as to compare HRQoL profile of patients who developed hearing loss following cisplatin-based chemotherapy and received audiological intervention and those who did not develop hearing loss.The outcome of this study will yield evidence that will guide clinicians when making decisions aimed at optimizing the HRQoL of patients who develop cisplatin-induced hearing loss following chemotherapy.